Deb's Blog

The older we get, the greater the risk of falling. Lost flexibility, diminished sense of balance, medications that cause dizziness or weakness, lack of attention, nerve damage to feet, chronic disease that takes a toll—any or all may contribute to a dangerous misstep.

A broken wrist, ankle or hip can be a major set-back for anyone; all the more so for a fragile older adult. But public health officials have identified another, growing risk for elders who fall: brain injury. According to a March report by the Centers for Disease Control, 2.8 million people suffered traumatic brain injuries (TBIs) in 2013 that resulted in emergency department visits, hospitalizations and deaths, with older adults accounting for the highest rate of TBIs—roughly one out of every fifty Americans aged 75 and older.

In addition, the CDC study found that the rate of hospitalizations for TBIs among these older adults jumped 27 percent between 2007 and 2013, “primarily because of falls.” Men across all age groups had a higher incidence of severe TBIs than women.

While the reasons for the increased rate of falls among older adults is unclear, the risks of brain injury for elders are significant. As we age, we shrink—including our brains. That process leaves more space between the brain and inside skull wall—a harder internal knock in case of a fall. Blood vessels connecting the brain and skull also get thinner and more easily damaged with age, increasing the possibility of a brain bruise, or subdural hematoma, which is effectively a slow leak. For those on blood thinners or anti-inflammatory medications, this kind of injury can morph into a severe health crisis. Moderate to severe TBIs also increase the risk of dementia significantly, anywhere from 2- to 4-fold.

While it’s impossible to prevent all falls, there are steps you can take to safeguard your loved one from unnecessary fall risk, as well as strengthen her odds (and yours!) of maintaining balance:

Make surfaces safe. One of the easiest ways to minimize falls is to stabilize throw rugs with slip-proof backings or remove them altogether. If the rugs have sentimental value, consider creative repurposing, such as turning them into wall hangings. Use bathtub liners with suction cups. Mark outdoor steps with reflective tape. Add grab bars to toilets and showers, if needed. Be sure that stairs have sturdy railings.

Wear well-fitting shoes and slippers. Loose slippers or house shoes may be more comfortable for elders struggling with bunions, neuropathy, arthritis or other forms of foot pain, but floppy foot-ware can also cause falls. An increasing number of shoe brands are now available with removable insoles for custom orthotics. A good podiatrist can provide essential foot care and recommendations for appropriate support.

Understand medication side effects. Blood pressure meds can cause weakness or dizziness if your loved one stands suddenly. Pain meds can, too; they can also cause blurred vision or confusion. Sleep aids can be particularly risky for elders, and psychotropic medications require careful monitoring. Not all side effects are obvious; be sure that you and your loved one are fully aware of associated fall risks for all his medications—and arrange for extra help, as needed. Be especially careful to monitor side effects when your loved one starts any new meds.

Illuminate hallways, stairs and walkways. A simple nightlight can help prevent a fall on the way to the bathroom. Motion sensors for both nightlights and outdoor lighting around stairs and walkways can provide needed illumination without driving up electric bills.

Have regular eye check-ups. Blurred vision accounts for falls, as well. Be sure that your loved one has appropriate, up-to-date eyeglasses and annual ophthalmologist appointments to evaluate her for glaucoma and cataracts.

Use a medical alert device. A variety of devices worn as pendants or bracelets contact emergency support if the wearer falls. Smartphones are not really a substitute; your loved one might not be carrying his phone at all times, or he could drop it if he falls. Worse, if he loses consciousness from a fall, a smartphone is useless. Make sure your loved one actually wears the device!

Exercise for strength, flexibility and balance. This is probably the most important factor: fight the urge to become sedentary with age. The more we move, the greater our ability to retain strength, flexibility and good reflexes in case of lost balance. Strength workouts help to maintain bone mass. Exercises such as Pilates, yoga and t’ai chi improve core strength and balance. Walking outdoors on an even surface revives energy and mental clarity. Even a few minutes a day standing on one foot can make a difference. Consider arranging a session or two with a physical therapist or personal trainer to put together a realistic exercise program for your loved one.

President of Deborah Fins Associates, PC, since 1995, Deborah Liss Fins is a licensed independent clinical social worker and certified Aging Life Care™ manager. Drawing on more than 30 years of professional experience in aging life care management, DFA offers comprehensive assessments and planning, guidance in selecting appropriate care, help identifying resources for financial support and professional consulting. Please contact us to set up a complimentary initial telephone consultation.

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